PROJECT SUMMARY/ABSTRACT The growing burden of alcohol consumption on health and society at both the national and the international level have contributed to the raising awareness and interest in effective alcohol control policy. In the United States (U.S.), there are approximately 80,000 deaths each year attributed to alcohol use. Healthcare costs alone are estimated at $25.6 billion, with the full societal cost of excessive drinking exceeding $220 billion. At the global level, alcohol use is the third leading risk factor for poor health and was the cause of 4% of all deaths worldwide in 2004. Among young people between the ages of 15 and 29, nine in ten deaths are due to alcohol-related causes. However, the relative scarcity of well-grounded and comprehensive analytic tools often prevents national and international policy bodies from considering the full range of costs and consequences of different policy actions. In this 5 year project, we propose to build an integrated decision-support platform that can be used to conduct evaluations of the health, social and economic impacts of alternative alcohol policies within and across national jurisdictions. The specific aims of this project are to do the following: (1) Develop, test and validate a dynamic microsimulation modeling platform, capturing both individual and social dynamics of alcohol use for the U.S. and a selection of six other relevant high- and middle-income countries; (2) Use the platform to project the health, social and economic consequences associated with current alcohol-use patterns; and (3) Assess the outcomes and costs of three alcohol control policies (pricing policies, blood alcohol concentration levels, and treatment) at reducing the social harms associated with alcohol misuse. Our model will track individuals' alcohol consumption on a per drink basis and capture key diseases and health outcomes, health service utilization and costs, and productivity impacts across the U.S. and six other countries, thereby enabling the model to consider important interactions between policy and social structures. Importantly, a novel estimation process is proposed that will rigorously quantify the effect of parameter uncertainty on results. This improvement in model estimation will enable more effective evaluation of the impacts of prevention and treatment strategies and has the potential to influence the social-policy modeling field. Countries to be included in the platform are: Canada, Chile, Finland, Mexico, the Russian Federation, the United Kingdom and the United States. Our internationally comparable platform will enable U.S. policy makers and researchers to evaluate, for the U.S., the impact of alcohol policies implemented elsewhere: including higher alcohol taxes and more affordable treatment.